You are assessing a patient with an altered mental

Question 1 of 5

You are assessing a patient with an altered mental status and has a diabetic history. Which of the following would most likely indicate the patient is suffering from diabetic ketoacidosis?

A. Cool, moist skin, wet mucous membranes, normal pulses and blood pressure, shallow respirations, and family members report increasing hunger and then nausea in the patient before calling 9-1-1 B. Red hot skin, wet mucous membranes, weak tachycardic pulses, hypotension, shallow rapid respirations, and family members report that the patient spoke of a loss of appetite for several days before calling 9-1-1 C. Dry, doughy-looking skin that is cool to the touch, unresponsiveness, bradycardic pulse, normal blood pressure, slow, shallow respirations, and family members report that the patient spoke of increasing intolerance to cold for several days before calling 9-1-1 D. Dry skin, dry mucous membranes, hypotension, shallow rapid respirations, and family members report that the patient spoke of increased thirst and frequent urination for several days before calling 9-1-1

Correct Answer: D

Rationale: The correct answer is D because the patient with diabetic ketoacidosis typically presents with dehydration, which is indicated by dry skin and mucous membranes. The increased thirst and frequent urination reported by family members are classic symptoms of uncontrolled diabetes leading to DKA. Hypotension and shallow rapid respirations are also common in DKA due to the metabolic acidosis. Choices A, B, and C are incorrect because they do not align with the typical presentation of diabetic ketoacidosis. Choice A describes a patient with hypoglycemia. Choice B describes a patient with septic shock. Choice C describes a patient with hypothermia. Therefore, based on the symptoms described and the patient's diabetic history, choice D is the most likely indication of diabetic ketoacidosis.

Question 2 of 5

When considering the administration of cardiac medication to a severely hypothermic patient in cardiac arrest, which of the following is true?

A. Cardiac medications are appropriate as long as warm fluid is being administered and active rewarming procedures initiated B. IV medication may be administered but spaced at longer than standard intervals C. The patient will most likely not respond to cardiac medication and allow toxic accumulation of the medications D. The patient will best respond to higher than normal doses of cardiac medications

Correct Answer: B

Rationale: The correct answer is B because in a severely hypothermic patient in cardiac arrest, the body's metabolism is slowed, affecting drug absorption and metabolism. Administering IV medications at longer intervals helps prevent toxicity as the body cannot process them efficiently. Choice A is incorrect because warm fluid and active rewarming are not sufficient to address medication metabolism issues. Choice C is incorrect as toxicity is a concern due to impaired drug clearance. Choice D is incorrect as higher doses can lead to toxicity in a hypothermic patient.

Question 3 of 5

You are called to assist a 20-year-old male for a severe headache. On-scene, you learn the patient was involved in an accident that caused a potential closed head injury. However, at the time of the accident, the patient refused EMS care, stating he felt fine. Today, he is experiencing headache, confusion, and visual disturbances. Which of the following injuries is most likely to cause this type presentation?

A. Coup-contra-coup injury B. Diffuse axonal injury C. Subdural hematoma D. Epidural hematoma

Correct Answer: C

Rationale: Rationale: The correct answer is C: Subdural hematoma. Subdural hematoma is a collection of blood between the dura mater and arachnoid mater of the brain, often caused by head trauma. Symptoms include headache, confusion, and visual disturbances, which align with the patient's presentation. Subdural hematomas can develop gradually after a head injury, leading to delayed symptoms. Other choices: A: Coup-contra-coup injury - This injury involves the brain hitting the skull on both sides due to acceleration-deceleration forces, but it typically presents with focal neurological deficits rather than the diffuse symptoms described. B: Diffuse axonal injury - This injury involves widespread damage to nerve fibers in the brain, leading to coma or altered consciousness rather than confusion and visual disturbances. D: Epidural hematoma - This injury is a collection of blood between the skull and dura mater, typically causing rapid deterioration in mental status and focal neurological deficits, not confusion

Question 4 of 5

The primary indication for transferring a patient to a higher level trauma center is:

A. Unavailability of surgeon or operating staff B. Multiple system injuries, including severe head injury C. Resource limitations as determined by the transferring doctor D. Resource limitations as determined by the hospital administration

Correct Answer: C

Rationale: Step-by-step rationale for the correct answer (C): 1. Transferring doctor determines resource limitations to provide adequate care. 2. Ensures patient receives necessary resources at a higher level trauma center. 3. Improves patient outcomes and chances of survival. 4. Avoids delays in treatment due to resource constraints. 5. Upholds the principle of providing the highest standard of care to the patient. Summary: A: Unavailability of staff is not the primary indication for transfer. B: While severe injuries warrant transfer, the primary reason is resource limitations. D: Hospital administration's decision may not always align with patient care needs.

Question 5 of 5

Which of the following statements is FALSE concerning Rh-isoimmunization in the pregnant trauma patient?

A. It occurs in blunt or penetrating abdominal trauma B. Minor degrees of fetomaternal hemorrhage produce it C. A negative Kleihauer-Betke test excludes Rh-Isoimmunzation D. This is not a problem in the traumatized Rh-positive pregnant patient

Correct Answer: C

Rationale: The correct answer is C because a negative Kleihauer-Betke test does not completely exclude Rh-isoimmunization in pregnant trauma patients. The test is used to estimate the amount of fetal-maternal hemorrhage and guide Rhogam administration, but it is not foolproof. Trauma can cause significant fetal-maternal hemorrhage, leading to Rh-isoimmunization even if the test initially shows negative results. Choice A is incorrect because Rh-isoimmunization can indeed occur in both blunt and penetrating abdominal trauma. Choice B is incorrect as even minor degrees of fetomaternal hemorrhage can lead to Rh-isoimmunization. Choice D is incorrect as Rh-isoimmunization is a concern in both Rh-negative and Rh-positive pregnant trauma patients due to the potential for fetal-maternal hemorrhage.

You are assessing a patient with an altered mental status and has a diabetic history. Which of the following would most likely indicate the patient is suffering from diabetic ketoacidosis?

Nurselytic

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